Pediatric neurology

When should you schedule a consultation with a pediatric neurologist?

Not all neurological disorders develop suddenly or cause severe pain. In many cases, the first signs are changes in a child's development, behavior, sleep, or coordination. A consultation with a pediatric neurologist helps identify the underlying cause of these symptoms, assess the functioning of the nervous system, and, when necessary, begin treatment at an early stage.

A consultation with a pediatric neurologist is recommended if your child:

• has a developmental delay – is not able to hold their head up, roll over, sit, crawl, walk, or begin speaking according to expected developmental milestones;
• experiences frequent headaches, especially if they recur, become more severe, or are accompanied by nausea, vomiting, or dizziness;
• has seizures or episodes of loss of consciousness, regardless of how long they last;
• develops tics, such as frequent blinking, twitching of the facial or shoulder muscles, or repetitive movements or sounds;
• has sleep disturbances – wakes up frequently, has difficulty falling asleep, sleeps restlessly, or is suspected of having breathing pauses during sleep. In such cases, the physician may recommend sleep apnea diagnostics (ambulatory polysomnography);
• shows behavioral changes, including difficulty concentrating, hyperactivity, impulsive behavior, or significant changes in mood or emotions;
• has coordination or balance problems, frequently falls, walks unsteadily, or struggles with everyday movements;
• experiences hand tremors, muscle weakness, or numbness in the arms or legs;
• has recurring neck or back pain arises that limits activity;
• has enuresis or other bladder control problems after the age when bladder control is normally expected;
• the child was born after a complicated pregnancy or difficult delivery, has sustained a head injury, or requires ongoing follow-up with a pediatric neurologist;
• requires ongoing monitoring for an already diagnosed neurological condition, including epilepsy, muscle tone disorders, psychomotor developmental delay, ADHD, consequences of perinatal nervous system injury, or other neurological disorders.

If it is difficult for your child to visit the medical center because of their age, health condition, or limited mobility, Doctor Sam Medical Center also offers home consultations with a pediatric neurologist.

What does a pediatric neurologist assess during a consultation?

A pediatric neurologist evaluates not only specific symptoms but also the overall condition of a child's nervous system and whether their development is appropriate for their age. A comprehensive neurological assessment helps identify possible disorders, determine their underlying cause, and establish whether additional investigations, follow-up, or treatment are needed.During the consultation, the physician assesses:

• psychomotor development;
• muscle tone and muscle strength;
• reflexes;
• coordination and balance;
• sensory function;
• speech and language development;
• attention, memory, and behavior;
• previous examination results and the child's developmental progress, if they are already under neurological follow-up.

If necessary, the physician may recommend additional diagnostic tests or consultations with other specialists. When a comprehensive assessment of early childhood development is required, the ASQ-3 screening may be recommended. This standardized developmental screening tool evaluates communication, gross and fine motor skills, problem-solving abilities, and personal-social development according to the child's age.

Developmental milestones that should not be ignored

Up to 1 year of age

• does not hold their head up according to expected developmental milestones;
• does not roll over or sit independently;
• does not respond to parents' voices or other sounds;
• has unusually increased or decreased muscle tone;
• does not reach for toys or show interest in their surroundings.

From 1 to 3 years of age

• does not begin walking independently or has an unsteady gait;
• does not say their first words or form simple phrases;
• does not understand simple instructions or follow basic requests;
• loses previously acquired developmental skills;
• shows little interest in communication or interacting with others.

After 3 years of age

• has difficulty concentrating or remembering information;
• displays hyperactivity or impulsive behavior;
• frequently complains of headaches or dizziness;
• develops tics or has problems with coordination or balance;
• falls behind peers in speech, cognitive, or psychomotor development.

Not every developmental difference indicates a neurological disorder. However, timely consultation with a pediatric neurologist allows the child's nervous system to be thoroughly assessed, helps rule out serious neurological conditions, and ensures that appropriate follow-up or treatment can be initiated when necessary.